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Quality of life and clinical symptom improvement support prostatic artery embolization for patients with acute urinary retention caused by benign prostatic hyperplasia.
J Vasc Interv Radiol. 2013 Apr; 24(4):535-42.JV

Abstract

PURPOSE

To show that prostatic artery embolization (PAE) improves quality of life (QoL) and lower urinary tract symptoms in patients with acute urinary retention caused by benign prostatic hyperplasia (BPH).

MATERIALS AND METHODS

This was a single-center prospective study of PAE in 11 patients with BPH managed with indwelling urinary catheters. International Prostate Symptom Score (IPSS), ultrasound, magnetic resonance (MR) imaging, QoL, and urodynamic tests were used to assess outcomes. Prostate size ranged from 30 to 90 g, and embolizations were performed with 300-500-μm Embosphere microspheres.

RESULTS

The rate of technical success (ie, bilateral PAE) was 75%, and the rate of clinical success (ie, catheter removal and symptom improvement) was 91% (10 of 11 patients). Postembolization syndrome manifested as mild pain in the perineum, retropubic area, and/or urethra. Ten of 11 patients urinated spontaneously after Foley catheter removal 4-25 days after PAE (mean, 12.1 d). No major complications were observed. Follow-up ranged from 19 to 48 months. In an asymptomatic patient, a discrete area of hypoperfusion suggesting small ischemia of the bladder was observed on 30-day MR imaging follow-up, but the bladder was normal on 90-day MR imaging. After 1 year, mean prostate volume reduction was greater than 30%, symptoms were mild (mean IPSS, 2.8 ± 2.1; P = .04), no erectile dysfunction was observed, and QoL improved significantly (mean, 0.4 ± 0.5; P = .001) using the paired t test.

CONCLUSIONS

Patients with severe symptoms and acute urinary retention caused by BPH can be treated safely by PAE, which improves clinical symptoms and QoL.

Authors+Show Affiliations

Department of Radiology, University of Sao Paulo Medical School, Rua Teodoro Sampaio, 352/17, Sao Paulo 05406-000, Brazil. fcarnevale@uol.com.brNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23434084

Citation

Carnevale, Francisco C., et al. "Quality of Life and Clinical Symptom Improvement Support Prostatic Artery Embolization for Patients With Acute Urinary Retention Caused By Benign Prostatic Hyperplasia." Journal of Vascular and Interventional Radiology : JVIR, vol. 24, no. 4, 2013, pp. 535-42.
Carnevale FC, da Motta-Leal-Filho JM, Antunes AA, et al. Quality of life and clinical symptom improvement support prostatic artery embolization for patients with acute urinary retention caused by benign prostatic hyperplasia. J Vasc Interv Radiol. 2013;24(4):535-42.
Carnevale, F. C., da Motta-Leal-Filho, J. M., Antunes, A. A., Baroni, R. H., Marcelino, A. S., Cerri, L. M., Yoshinaga, E. M., Cerri, G. G., & Srougi, M. (2013). Quality of life and clinical symptom improvement support prostatic artery embolization for patients with acute urinary retention caused by benign prostatic hyperplasia. Journal of Vascular and Interventional Radiology : JVIR, 24(4), 535-42. https://doi.org/10.1016/j.jvir.2012.12.019
Carnevale FC, et al. Quality of Life and Clinical Symptom Improvement Support Prostatic Artery Embolization for Patients With Acute Urinary Retention Caused By Benign Prostatic Hyperplasia. J Vasc Interv Radiol. 2013;24(4):535-42. PubMed PMID: 23434084.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Quality of life and clinical symptom improvement support prostatic artery embolization for patients with acute urinary retention caused by benign prostatic hyperplasia. AU - Carnevale,Francisco C, AU - da Motta-Leal-Filho,Joaquim M, AU - Antunes,Alberto A, AU - Baroni,Ronaldo H, AU - Marcelino,Antonio S Z, AU - Cerri,Luciana M O, AU - Yoshinaga,Eduardo M, AU - Cerri,Giovanni G, AU - Srougi,Miguel, Y1 - 2013/02/19/ PY - 2012/09/12/received PY - 2012/12/18/revised PY - 2012/12/18/accepted PY - 2013/2/26/entrez PY - 2013/2/26/pubmed PY - 2013/9/17/medline SP - 535 EP - 42 JF - Journal of vascular and interventional radiology : JVIR JO - J Vasc Interv Radiol VL - 24 IS - 4 N2 - PURPOSE: To show that prostatic artery embolization (PAE) improves quality of life (QoL) and lower urinary tract symptoms in patients with acute urinary retention caused by benign prostatic hyperplasia (BPH). MATERIALS AND METHODS: This was a single-center prospective study of PAE in 11 patients with BPH managed with indwelling urinary catheters. International Prostate Symptom Score (IPSS), ultrasound, magnetic resonance (MR) imaging, QoL, and urodynamic tests were used to assess outcomes. Prostate size ranged from 30 to 90 g, and embolizations were performed with 300-500-μm Embosphere microspheres. RESULTS: The rate of technical success (ie, bilateral PAE) was 75%, and the rate of clinical success (ie, catheter removal and symptom improvement) was 91% (10 of 11 patients). Postembolization syndrome manifested as mild pain in the perineum, retropubic area, and/or urethra. Ten of 11 patients urinated spontaneously after Foley catheter removal 4-25 days after PAE (mean, 12.1 d). No major complications were observed. Follow-up ranged from 19 to 48 months. In an asymptomatic patient, a discrete area of hypoperfusion suggesting small ischemia of the bladder was observed on 30-day MR imaging follow-up, but the bladder was normal on 90-day MR imaging. After 1 year, mean prostate volume reduction was greater than 30%, symptoms were mild (mean IPSS, 2.8 ± 2.1; P = .04), no erectile dysfunction was observed, and QoL improved significantly (mean, 0.4 ± 0.5; P = .001) using the paired t test. CONCLUSIONS: Patients with severe symptoms and acute urinary retention caused by BPH can be treated safely by PAE, which improves clinical symptoms and QoL. SN - 1535-7732 UR - https://www.unboundmedicine.com/medline/citation/23434084/Quality_of_life_and_clinical_symptom_improvement_support_prostatic_artery_embolization_for_patients_with_acute_urinary_retention_caused_by_benign_prostatic_hyperplasia_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1051-0443(12)01316-4 DB - PRIME DP - Unbound Medicine ER -